Cardiovascular Effects of Glucagon-Like Peptide-1 Receptor Agonists.
10.3803/EnM.2016.31.2.258
- Author:
Yu Mi KANG
1
;
Chang Hee JUNG
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. chjung0204@gmail.com
- Publication Type:Clinical Trial ; Review
- Keywords:
Glucagon-like peptide 1;
Cardiovascular;
Effect
- MeSH:
Appetite;
Biomarkers;
Cardiovascular Diseases;
Cardiovascular System;
Endothelium, Vascular;
Glucagon;
Glucagon-Like Peptide 1*;
Glucagon-Like Peptide-1 Receptor*;
Humans;
Incretins;
Insulin;
Myocardium;
Proglucagon
- From:Endocrinology and Metabolism
2016;31(2):258-274
- CountryRepublic of Korea
- Language:English
-
Abstract:
Glucagon-like peptide-1 (GLP-1) is a member of the proglucagon incretin family, and GLP-1 receptor agonists (RAs) have been introduced as a new class of antidiabetic medications in the past decade. The benefits of GLP-1 RAs are derived from their pleiotropic effects, which include glucose-dependent insulin secretion, suppressed glucagon secretion, and reduced appetite. Moreover, GLP-1 RAs also exert beneficial roles on multiple organ systems in which the GLP-1 receptors exist, including the cardiovascular system. Cardiovascular effects of GLP-1 RAs have been of great interest since the burden from cardiovascular diseases (CVD) has been unbearably increasing in a diabetic population worldwide, despite strict glycemic control and advanced therapeutic techniques to treat CVD. Preclinical studies have already demonstrated the beneficial effects of GLP-1 on myocardium and vascular endothelium, and many clinical studies evaluating changes in surrogate markers of CVD have suggested potential benefits from the use of GLP-1 RAs. Data from numerous clinical trials primarily evaluating the antihyperglycemic effects of multiple GLP-1 RAs have also revealed that changes in most CVD risk markers reported as secondary outcomes have been in favor of GLP-1 RAs treatment. However, to date, there is only one randomized clinical trial of GLP-1 RAs (the ELIXA study) evaluating major cardiovascular events as their primary outcomes, and in this study, a neutral cardiovascular effect of lixisenatide was observed in high-risk diabetic subjects. Therefore, the results of ongoing CVD outcome trials with the use of GLP-1 RAs should be awaited to elucidate the translation of benefits previously seen in CVD risk marker studies into large clinical trials with primary cardiovascular outcomes.
